| NPI | 1891398285 |
|---|---|
| Doing Business As | WISE MIND ONLINE THERAPY |
| Entity Type | Organization |
| Authorized Contact | TRAVIS REED STEPHENS Owner / Share Holder 208-243-3332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2020-11-18 |